LIBRARY OF CONGRESS. 

©Iptjt. ©opgrig^i l|o.- 

Shelf»_.L.!.5* 



UNITED STATES OF AMERICA. 



;: . 



v'b 



•J* 



HAND BOOK 



OF 



^UROSCOPY^ 



FROM NOTES TAKEN IN THE LABORATORY OF 



Jo H. LlNSLEY, M. D„ 



BY 



SUMNER GLEASON, 



STENOGRAPHER, 



BURLINGTON, 




VERMONT, 



]B. g, Styles, Pki^tep, Pvklifgtqjt, Vt. 






Copyright, 1882, 

BY 

SUMNER GLEASON. 



PHYSICAL PROPERTIES 



CHAPTER I. 

The Urine is the typical excretion of the body. It is the 
product of change of animal tissue, and is excreted from 
the Malpighian bodies and convoluted tubes of the kidney. 
The kidneys have nothing to do themselves with the forma- 
tion of the urinary principle; they simply purify the blood 
by separating the effete matters, and the urine is simply a 
solution of urea and chloride of sodium with more or less of 
the organic and inorganic constituents of the blood. 

If normal urine is allowed to stand uncovered for a while, 
a small cloud of mucus sinks to the bottom of the vessel. 

It is claimed that there is an acid and an alkaline fermen- 
tation of the urine. The acid fermentation is thought to 
be due to the decomposition of the extractive coloring mat- 
ter by the vesical mucus, producing lactic and acetic acids. 
The alkaline fermentation which takes place after the acid 
fermentation is due to the decomposition of urea. At this 
time you get the granules of urate of ammonium and 
microscopic crystals of urate of sodium. The acid fermen- 
tation of the urine is however doubted. 

The following names are given to the urine according to 
the hour in which it is passed: 

Urina Sanguinis, the urine that is first passed in the 
morning. It has a specific gravity of 1015 to 1025 or 1030. 



4 HAND-BOOK OF UROSCOPY. 

Urina Potus, that passed after large quantities of water 
have been taken. Specific gravity of 1002 to 1015. 

Urina Cibi, the urine of digestion ; which has a specific 
gravity of 1020 to. 1030. 

Urina Spastica, the urine of disease. 

Quantity. The quantity of urine in 24 hours is from 10 
to 52 ounces, or from 1200 to 1600 c. c. The most urine is 
passed in the afternoon, less in the morning, and least of all 
at night. 

The quantity of urine is increased normally by repose, ex 
posure to cold, dry skin, unusual imbibition, taking of food, 
after eating fruit, in winter, use of stimulants, diuretics, 
alkalies, salines, and by certain drugs as cantharides, opium, 
and belladonna. 

It is increased 2 m ^ i0 ^°9^ ca ^y i 11 convulsions, in acute 
diseases, after nervous attacks as hysteria, and in both 
forms of diabetes. 

It is diminished normally by the use of diaphoretics, or 
anything that will increase perspiration, and by the admin- 
istration of drastics. 

It is dimished pathologically in diseases producing anar- 
sarca and dropsy, suppression, uraemia, fevers, diarrhoea, 
nephritis, scarlatina, later stages of cardiac disorders, stage 
of collapse in cholera, all forms of Bright's disease except in 
the cirrhotic and lardaceous kidney. 

Color. The normal color of urine is a yellow with more 
or less admixture of red. 

The coloring matters are not definitely known, but later 
we shall consider two normal coloring matters of the urine, 
namely Urobilin and Indican. 



MYStCAL PROPERTIES. 

The urine first passed in the morning is the darkest, and 
that passed in the forenoon the palest. 

The color of course is subject to great variation in disease. 

The color table of Neubauer & Yogel is the one now used 
to determine the color of the urine by. It is composed of 
three sets of colors, pale urines, high colored urines, and 
the dark urines. 

A pale'urine long continued indicates a certain degree of 
anaemia, if the amount is normal. You get an almost color- 
less urine in the neuroses; and in a granular kidney the 
coloring matters are lost. 

Blood red, or high colored urines, are a dark yellow with 
tendency to flame red, and they generally depend upon the 
presence of Uroerythrine, an abnormal coloring matter 
present in fever. They are generally concentrated, have a 
large amount of solids, are acid, and contain a large per- 
cent of urea. 

The blood red, or garnet-red urines, are always caused by 
foreign coloring matters, as blood, etc. The dark urines 
are from diseases of the kidneys producing haemorrhage, 
also by passage of biliary coloring matters. In leprosy near 
death, the urine becomes a dark brown. It is a dark red 
daring the course of the disease. 

Green urine of a dirty hue, comes from jaundice caused 
by the presence of Biliverdin, and it has the same signifi- 
cance as brown icteric urine. 

We get a dirty blue urine in cholera and typhus fever, 
and at the same time we generally have a dark blue color to 
the skin. This urine has an alkaline reaction. 

Blood coloring matters may be from a doubtful origin. 
They may be excreted from the kidneys, or they may have 



6 HA3TD-B00K OF TEOSCOPY. 

arisen by tlie breaking down of the blood corpuscles in the 
urine. If from haemorrhage of large vessels, the urine con- 
tains mostly haemoglobin and is red. If from capillary 
haemorrhage, the urine contains mostly methaemoglobin, 
and has a brown color. The reason is, in capillary haemor- 
rhage the blood mixes with the urine slowly and is held 
longer in solution at the normal temperature of the body. 

The temperature, carbonic acid in the urine, and want of 
oxygen, furnish the necessary conditions for the change 
from haemoglobin to methaemoglobin. 

Haematuria occurs in constitutional diseases such as scrof- 
ula, purpura, and scarlatina. 

Then the urine may be of a muddy, brownish yellow 
color, from the presence of pus in cystitis, pyelitis, urethri- 
tis, gonorrhoea, abcess or suppuration of the bladder, pros- 
tate, or the urinary passages. 

Iron, logwood, carbolic acid, and tar give the urine a 
black color when absorbed into the system. Santonin, a 
yellow or brownish red. Rhubarb, senna, or haematoxylon 
give a reddish color, and this is distinguished from bile by 
the addition of liquor ammonia, which turns the vegetable 
coloring matter to crimson. Tannin taken by the mouth 
renders the urine colorless. 

An acid added to the urine after the taking of rhubarb or 
senna turns them a brighter color, and if it were blood it 
would be turned darker. 

Odor. The cause of the normal odor of urine is un- 
known. It is described as "urinous", or simply aromatic. 
Albuminous urine of a low specific gravity is almost odor- 
less. Most alkaline urines °'ive off an ammoniacal odor. 



PHYSICAL PROPERTIES. 7 

Saccharine urine gives a sweet whey-like odor. Some phos- 
phatic urines give an excessively fetid odor. 

The odor is strong in rheumatism, gout, acid indigestion, 
and catarrh of the bladder. This is intensified by the addi- 
tion of strong acids. 

After ingestion turpentine gives an odor of violets. As- 
paragus, copaiba, cubebs, sandal wood oil, garlic, saffron, 
and cauliflower, each give an odor to the urine peculiar 
to the substance taken. 

In paraplegia, the urine has a fetid odor soon after pass- 
ing. 

Consistence. As to the consistency of the urine, it is a 
limpid fluid; never anything else in health but aqueous, 
dropping and flowing readily. Pathologically it is viscid, 
glutinous, and divided into drops with difficulty. This may 
be due to an excess of pus or mucus, as in acute catarrh. It 
may be a mixture of pus and mucus, and may also be due 
to the action of an alkali on pus or albumen. 

The froth of normal urine readily disappears. If it is 
permanent, albumen, sugar, or bile pigments may be sus- 
pected. 

Specific Gravity. The specific gravity of the urine 
may be normally from 1005 to 1028, with an average of 
1020. It is always heavier than water. 

The specific gravity is reckoned by comparison with dis- 
tilled water. There are three ways in which it is obtained. 
First by the picnometer or specific gravity bottle, second by 
the urinometer or spindle, and third by the Mohr-Westphal 
balance. The temperature in all should be 60 degrees F., 
or 15 degrees C. 



8 HAND-BOOK OF UttOSCoPY. 

If the amount of urine be too small to use the spindle, 
add four volumes of water. Take the specific gravity and 
multiply excess over a thousand by 5 and add 1000. 

Example. Suppose after adding four volumes the spe- 
cific gravity is 1003; then 3 times 5 equals 15, plus 1000 
equals 1015, the specific gravity of the urine. 

In taking the specific gravity, a ' 'stand test tube'' should 
be used and the urine poured in at an obtuse angle, and the 
tube filled three-quarters full. The urinometer should then 
be introduced and the tube filled "to the brim" The spe- 
cific gravity should be read where the upper surface of the 
urine cuts the scale on the urinometer. 

The spindle should be gently touched on the end, causing 
it to descend to the bottom of the tube and back. This 
prevents any adhesions there might be between the sides of 
the tube and urinometer. 

The specific gravity is high in diabetes mellitus, rheuma- 
tism, gout, fevers, after prolonged exercise, after excessive 
perspiration, and the first stage of acute Bright's disease. 

It is low in albuminuria, pneumonia, in dilute urine, 
diabetes insipidus, after hysteria, in all forms of Bright's 
disease except acute nephritis. 

Where there is an obstruction of the ureter by calculi 
passing, the characteristics of the urine passed will be that 
it is small in quantity, pale in color, and of a low specific 
gravity. 

Solid Matters. The normal amount of solid matters in 
the urine is from 60 to 80 grams. May be determined by 
multiplying the last two figures of the specific gravity by 
either the coefficient of Trapp, (which is 2) or of Haser, 
(2.33). Multiplying by either of these coefficients gives the 



PHYSICAL PBOPERTIES. 

number of grams of solid matters in 1000 c. c. or a litre of 
urine. If solids amount to 200 grams, look for sugar. If 
20 grams, and the quantity not corre.^ondingly diminished, 
hydruria or watery urine. 

In fevers where the patients fast, 30 grams would be an 
average. If in pneumonia you have 40 grams upon a strict 
diet, the solids are increased at the expense of the tissues of 
the body. 

Urea and chloride of sodium are the principal normal 
solid matters of the urine. In 100 parts of solid matters, 
there are 50 of urea, 25 of chloride of sodium, and the other 
salts of the urine make up the remaining 25. 

Reaction. The reaction of urine is normally faintly 
acid. It is due to the acid phosphate of sodium and potas- 
sium. It may be normally neutral or faintly alkaline. 

If the urine is alkaline, it should be determined whether 
this alkalinity occurred before or after being voided. If a 
sample of urine is alkaline when examined, it should be 
ascertained whether this is due to a fixed, (sodium or potas- 
sium compounds) or to a volatile alkali (ammonia). This 
is determined by gently heating and drying the red litmus 
paper turned blue by the presence of an alkali. If when 
dry the red color returns, the alkalinity is due to a volatile 
alkali. If the blue color is permanent, it is due to sodium 
and potassium compounds. If due to sodium and potas- 
sium compounds, nothing pathological is indicated. If due 
to ammonia when passed, it indicates an inflammation 
somewhere along the genito-urinary tract, causing an increa- 
sed amount of mucus and of course with the decomposition 
of urea. 



10 HAND-BOOK OF UROSCOPY. 

The urine is strongly acid in rheumatism, gout, acid 
indigestion, after taking hot and highly nitrogenous stimu- 
lating articles of food, and alcohol. 

The urine may be alkaline normally in the middle of the 
forenoon, after a full meal, and after eating fruit. Patho- 
logically in severe forms of paraplegia, in cystitis, retention 
of urine, and when pus is present. It can hd made alkaline 
by the ingestion of the carbonates, acetates, citrates, or tar- 
trates of the alkalies. 



NORMAL CONSTITUENTS. 



CHAPTER II. 

Ueea. 

Urea, (CON 2 H 4 ) is the product of oxidation of the 
nitrogenous substances of the body. The average is 35 
grams in 24 hours. This may be in health considerably 
diminished or increased. It is found normally in the blood, 
bile, liver, amniotic fluid, vitreous and aqueous humors, 
and sweat. Not found in the muscle of man. It is soluble 
in water and alcohol. Insoluble in ether 

Urea exercises more influence on the specific gravity than 
any of the other normal constituents of the urine. In fact 
its weight is equal to the entire weight of the other normal 
constituents. Unless a fluid contain urea, it is not urine. 

The amount is increased after an animal diet, relatively 
in children though not absolute, during waking hours, in 
fevers up to the acme of the disease, and after, diminished 
below normal. 

The amount is diminished when urea is retained in the 
animal economy, on vegetable diet, toward the fatal termi- 
nation of disease, Bright's disease, at, night, and in strong 
ammoniacal urine. 

In diabetes mellitus if much sugar be present, the urea 
is diminished in per cent., though the total quantity in 24 
hours is increased. 



12 HA^D-BOOIv OF UEOSCOPY. 

Test. Take two samples of the urine and evaporate one 
sample to one-half the quantity, and then bring a drop of 
this in contact with a drop of nitric acid on a glass slide. If 
crystals of nitrate of urea do not form immediately, urea is 
diminished. Take a drop of the sample that is not evapo- 
rated and bring it in contact with a drop of nitric acid, and 
if crystals of nitrate of urea form immediately after adding, 
the urea is increased. 

The amount of urea can readily be determined by com- 
parison, in the absence of sugar or albumen. For instance, 
we have a specific gravity of 1025 normally. If the chlor- 
ides are found to be normal, then urea will be said to be 
normal, because there can be nothing else normally besides 
urea that w T ill make up this amount of solids, the other 
salts exerting but very little influence on the specific 



gravity 



Chlorides. 



The chlorides found in the urine are principally the chlo- 
rides of sodium and potassium. There is also ammonium 
chloride and possibly calcium chloride. The average is 
14.73 grams in 24 hours. 

The secretion of the chlorides is greatest in the afternoon 
and least at night. They are increased at first by drinking- 
water, and later on, diminished : are increased with a lib- 
eral salt diet and with energetic bodily or mental exercise. 
Increased during the paroxysms of intermittent fever, and 
the day after they are diminished. Also diminished in 
acute rheumatism. Increased in diabetes insipidus, in 
dropsy when diuresis comes on, febrile diseases when there 
are any serous exudations or watery discharge, in chronic 



NORMAL CONSTITUENTS. 13 

affections accompanied by impaired digestion. They are 
said to be entirely absent from the urine during the height 
of pneumonia, and their reappearance is a sympton of im- 
provement in the patient's condition. When not found in 
the urine, they are found in some of the other secretions, as 
the saliva. The amount seemingly depends upon the di- 
gestive powers of the patient. 

Test. First add a drop or two of nitric acid to hold the 
phosphates in solution. Then add two or three drops of a 
solution of nitrate of silver, and if normal the chlorides are 
thrown down as a white curdy precipitate. 

The ability to calculate the normality or abnormality of 
the different normal ingredients of the urine by qualitative 
analysis, can only be learned accurately by experience. 

The Earthy and Alkaline Phosphates. 

The earthy phosphates are the phosphates of calcium and 
magnesium. Average amount is from 1 to \\ grams in the 
24 hours. 

The amount of magnesium phosphate is double that of 
the calcium phosphate. If the acid magnesium phosphate 
is acted on by ammonia, an ammonium magnesium phos- 
phate is formed. 

The earthy phosphates ;ire increased in diseases of bones, 
especially when diffuse, as diffuse periostitis, rachitis, and 
arthritis. Also diseases of nerve centers, after great mental 
strain, after use of mineral waters rich in carbonates, and 
with exclusive meat diet, though not constant. 

They are diminished in kidney difficulties. 

Test, Hoffmann and Ultzmann. A test tube, 16 cen- 



14 HAXD^OOK OF UROSCOPY. 

timeters long, 2 centimeters wide, is filled one-third full 
with clear or filtered urine. Add a few drops of liquor po- 
tassa or ammonium hydrate, and warm until the earthy 
phosphates separate out as a fioculent precipitate. After 
setting aside for 10 or 15 minutes to settle, we can Approxi- 
mately estimate the amount. If the layer of earthy phos- 
phates is 1 centimeter high, the phosphates are normal. If 
the layer is 2 or 3 centimeters high, the earthy phosphates 
are increased. If on the contrary only single flakes appear, 
then they are diminished. 

The alkaline phosphates are the acid sodium phosphate 
and possibly the potassium phosphate. They average from 
2 to 4 grams in the 24 hours. 

The monophosphate of sodium, (P0 4 H 2 NA,) causes acid 
reaction of the urine more than any other. 

The acid phosphate of sodium, (P0 4 HNA 2 ,) and neutral 
phosphate of sodium, (P0 4 NA 3 ,) are alkaline in reaction. 

The amount is influenced by the food. They are quite 
soluble in water and alkaline fluids. Two-thirds of all the 
phosphoric acid is in combination with the alkalies. 

The alkaline phosphates are increased by inflammation 
and fevers. 

Both forms of phosphates if deposited in the urine indi- 
cate an alkaline reaction, and are favorable to the formation 
of phosphatic calculi. 

Test. To a small quantity of urine in a test tube, add 
about one-third of the magnesium mixture. If the precipi- 
tate present a whitish granular appearance, the alkaline 
phosphates are normal. If on the contrary the color ap- 
proaches a milky appearance, they are increased. On the 
other hand if only a slight precipitate is noticed, then they 
are diminished. 



NORMAL CONSTITUENTS. 15 



Phosphoric Acid. 



The amount of phophoric acid is from 2.3 to 3.8 grams 
in 24 hours. Average, 2.8 grams. 

It is increased after the ingestion of phosphorus or the 
phosphates, after a principally meat diet, with common fe- 
brile disease, though not constant. 

It is diminished in urines of low specific gravity, in the 
urina potus and spastica, kidney and heart diseases with less 
amount of urine, severe disorders of digestion, all chronic 
diseases of the brain except epilepsy. 

In the urine, phosphoric acid, or or triphosphoric acid is 
combined with the alkaline earths. 

Sulphates, 

The sulphates are principally of sodium and potassium, 
sulphate of sodium being the most abundant. The average 
amount in 24 hours is from 2 to 2.1 grams. They are 
mostly influenced by the food. 

They are greatest during digestion, and are increased 
upon drinking water, decreased after. Pure sulphur in- 
creases them and also a meat diet. They are increased in 
acute febrile processes, with a large excretion of urea. The 
greatest increase is noticed in meningitis, enchephalitis, 
rheumatism, and affections of the muscular system causing 
waste of tissue. 

They are diminished with exclusive vegetable diet, in be- 
ginning of typhus fever, and (in per cent.) in all urines of a 
low specific gravity. 

Their increase or decrease is not of great account in 
disease. 



1G HAND-BOOK OF UEOSCOPY. 

Test. As a solution of chloride of barium added to the 
urine precipitates the phosphate of barium (as well as the 
sulphate.) we add a drop or two of hydrochloric acid to a 
small quantity of urine in a test tube, and then one-third as 
much of the chloride of barium solution as we have urine to 
be tested. If the sulphates are normal, we observe a milky 
appearance. If the sulphates are increased, this is more of 
a creamy consistency: and if diminished, on the other hand, 
the color is lighter. 

Coloring Matters. 

The coloring matters are not definitely settled. Urobilin 
and indican will be considered as the normal coloring mat- 
ters of the urine. 

Urobilin. 

It is supposed to be a reduction product of the coloriDg 
matter of the bile, bilirubin, though it is more likely to be 
the product of haemoglobin. Urobilin is the same sub- 
stance which is spoken of in different works as urophain, 
urohaBmatin, and urochrome. A pale urine may contain 
much urobilin. It is especially abundant in high colored 
urines of fevers. 

Test. Pour a layer of pure sulphuric acid into a small 
beaker, then pour on this from the height of about ten 
inches twice as much urine. If urobilin is normal, a deep 
garnet red color will be observed. If increased, the color 
will be darker and opaque ; and if diminished, of course 
lighter. 



normal constituents. 17 

Indican. 

Indican is the same as the uroxq,th(in of Heller, and indi- 
gogen of Thudichnm. 

Pathological Significance. Increased by an exclusively 
meat diet, in Addison's disease, cholera, carcinoma of liver 
and stomach, in all diseases which threaten closure of the 
small intestine, (though not so much so in stoppage of the 
large intestine), peritonitis, chlorosis, in chronic diseases, 
inanition and cirrhosis of the liver, pyelitis, and diseases of 
the spinal cord. 

Certain drugs, as turpentine, mix vomica, and the oil of 
bitter almonds, also increase it. 

Test. To a little pure hydrochloric acid in a test tube, 
(about 6 cubic centimeters) add 5 or 6 drops of the urine to 
be tested. Heat, and if the color is a pale yellowish red, 
indican is present in normal amount. If it turn a purple or 
violet color, it is increased. 



Uric Acid. 

Uric Acid, (C 5 N 4 H 4 3 ), is a less oxidized stage of urea, 
and is only found as a sediment when the urine is very acid. 
It is found in the urine of all classes of animals ; occurs even 
in the very lowest orders ; in the excrement of birds, snails, 
reptiles, and insects ; is found normally in the blood of hens. 
It is constantly increased in the blood in gout. Has also 
been found in the spleen, lung tissue, and gouty deposits. 
Its quantity is not so much dependent upon food as urea. 
It is soluble with difficulty in cold water, but more readily 
soluble in warm. Is generally found combined in the urine 
with its salts, as with the urates. 

It is increased by indigestion, poor nutrition, in most 



18 HAND-BOOK OF UROSCOPY. 

febrile conditions, more especially with disorders of the res- 
piratory organs and disturbances of the circulation, rich 
animal diet, by too little exercise in open air, acute febrile 
processes which cause much breaking down of the nitrogen- 
ized elements of the body, in lung and heart diseases where 
there is dyspnoea, where the diaphragm is impeded in its 
function as by large tumors in the abdominal cavit}^ and by 
impoverished blood. 

It is diminished in chronic affections of the kidneys, some- 
times in diabetes mellitus, in hydruria, arthritis, and during 
paroxysms of gout. 

Murextd Test. When present in the urine as a precip- 
itate, we filter the urine and dry the filter, and then collect 
the sediment in a porcelain capsule. Add a few drops of 
nitric Jicid and warm carefully until dissolved ; then evapo- 
rate slowly with great care to near dryness and add a drop or 
two of ammonium hydrate. If uric acid is present, we get 
a purple red color, (murexid acid, or purpurate of ammonia.) 

If a drop of a solution of nitrate of silver in the cold be 
brought in contact with a drop of a solution of uric acid, you 
have a brownish yellow or black spot, according to the amount 
of uric acid present. 

To obtain uric acid from the urine, add one part of hydro- 
chloric acid to eight parts of the urine, set aside for 24 hours 
and collect as above stated. 

Urates. 

The urates are salts of uric acid. They are the urates of 
sodium, potassium, ammonium, calcium and magnesium. 
Urate of sodium is the most common. Ammonium next. 
They are soluble at the temperature of the body and in alka- 



NORMAL CONSTITUENTS. 19 

line solution. Are generally deposited during fevers, after 
copious perspiration. A precipitate of them is favored by 
concentration of the urine either by adding uric acid or by 
taking away the water, by the cooling of the urine, and by 
moderate acidity of it. If the urine is strongly acid, it 
throws down the uric acid instead of the urates. 

Test. — The urates are the only deposit found in the urine 
which clear up on the application of heat. 

Mucus. 

There is always present in the urine a small quantity of 
mucus. This may be seen in time by allowing the urine to 
settle in a beaker, when the mucus will be observed as a lit- 
tle cloud floating below the middle of the liquid. It may 
be present in considerable quantities and still not to be seen 
owing to the transparency. If there is no color, and if there 
be a large quantity of mucus suspected, color the urine and 
then precipitate the mucus by alcohol which has some tinct- 
ure of iodine in it. May also be precipitated by acetic acid 
with iodine in solution with potassium iodide. Urine con- 
taining much mucus filters badly. It is increased princi- 
pally from irritation from the urinary tract. As a rule 
there is a larger amount in the urine in females than in that 
of males. Mucus may be separated from the urine by filtra- 
tion, when it will be seen on the filter as a glistening coat of 
varnish. • - . • - ■ . . 

Other Normal Constituents of the Urine. 

Creatine, Creatinine, Xanthin, Hippuric Acid, Oxalic 
acid, Lactic and Phenylic acids, are also normal constituents 
of the urine, but will not be here spoken of. 



ABNORMAL CONSTITUENTS, 



CHAPTER III. 

ALBUMEN". 

Albumen is the most important substance which the body 
requires for its preservation. It is the chief constituent of 
the blood, lymph, chyle, serous fluids, and the liquids of the 
cellular tissue. It is found in the urine after the use of 
egg albumen. Serum albumen may appear in very small 
quantities (from one to one-tenth per cent.) in the urine of 
a man healthy to all appearances, without serious conse- 
quences. What causes this is not known. The urine thus 
discharged is concentrated very highly, strongly acid, and 
contains a large quantity of urea and also uric acid. The 
reason why albumen is not found in the normal urine, is 
because it penetrates animal membranes with difficulty, and 
only under great pressure, unless there be destruction of the 
urinary tubules. 

It is found in the urine pathologically when the blood 
pressure is greater than normal, in heart disease or impeded 
venous circulation, and most frequently in those affections 
of the kidney which are classed under the head of Bright's 
disease ; or in other words, those diseases which involve an 
alteration of the diffusion membrane of the kidney. The 
Royal College of Physicians of London include all diseases 



ABNORMAL CONSTITUENTS. 21 

of the kidney productive of albuminuria as Bright's disease, 
and these are nephritis, nephritis albuminosa, inflammation 
of the malpighian bodies, granular kidney, cachectic nephri- 
tis, tubal nephritis, amyloid diseases of the kidney, etc. It 
is found, too, if blood, pus, or other albuminous fluid is 
mixed in the urine. This condition is termed false albumin- 
uria. x\lso, it is sometimes found where there is imperfect 
nutrition of the capillary wall. This is termed hydremia. 

Tests. — Heat and the nitric acid tests are the only two 
responsible tests for the determination of the presence of 
albumen in the urine. 

Take a small quantity of the urine in a test tube, if not 
acid, acidulate carefully with one or two drops of acetic acid, 
and heat. Nitric acid if added might form with the albu- 
men an acid albuminate which would not be precipitated on 
the application of heat. Also, if an alkali was added in 
excess, an alkali albuminate would be formed and again the 
albumen would not be precipitated upon heating the urine. 
If a cloudiness occur after the urine is boiled for a few seconds 
it may be the earthy phosphates or albumen. Add a drop or 
two of nitric acid. If the cloudiness disappear, it is due to 
the earthy phosphates, and if it is still present albumen is 
found. 

Nitric acid, or Heller's Test. Fill a test tube to 
about half an inch with pure nitric acid. Float carefully 
upon this a layer of urine to be tested. If a white ring be 
formed between the two liquids, it maybe either albumen, 
the urates, or a resinous substance found in the urine after 
the ingestion of copaiba or oil of turpentine. To distin- 
guish between albumen and the urates, we heat the liquid. 
If this ring clears up, it is due to the urates ; if not to albu- 



22 HATO-BOOK OF UROSCOPY. 

men or the resin. To determine whether it be this sub- 
stance (found in the urine from the ingestion of the aboxe 
medicines) or albumen, add a few drops of alcohol. If it 
clear up, it is due to the substance above referred to. If 
not, if the ring is still present on the application of the 
above tests, we are positive albumen is in the urine. 

When sulphuric acid is added to albumen, we get a violet 
color. 

Concentrated nitric acid with heat gives a yellow color, 
then the addition of sodic hydrate gives an orange red color. 

Also, most of the metallic salts as mercuric chloride and 
alum precipitate albumen. 

Application of Trommer's test gives a violet color. 

Sugar. 

Grape'sugar is identical with diabetic sugar. 

Sugar is found normally in the contents of the small in- 
testine, chyle, after taking food containing sugar or starch, 
in the hen's egg both in the process of hatching and in those 
not being hatched, in the yolk as well as the white, in the 
amniotic and allantois fluid of cows, sheep and swine, and 
in the liver. There is no sugar in the urine normally. 

When it is present in diabetes mellitns, it is also present 
in the blood and vomited matters, saliva, sweat, etc. Sugar 
is sometimes found temporarily in certain diseases. Also 
found in disturbances of the abdominal circulation, in con- 
vulsions, from some acute diseases especially cholera, when 
there are carbuncles, after severe burns, typhus fever, some- 
times in rheumatic fever, and acute encephalitis. By 
wounding certain points of the medulla in animals, sugar is 
temporarily present in the urine. 



NORMAL CONSTITUENTS. 



2d 



Many diabetic urines have an odor somewhat like chloro- 
form. 

Tests. Moore's or Hellers Test. Take two volumes of 
urine and one volume of liquor potassa in a test tube, and 
boil. If sugar is present, we observe a color varying from a 
pale red to a deep wine color, according to the amount of 
sugar present. 

Boettger's Test. Add to a small quantity of urine in a 
test tube, a few drops of a solution of carbonate of soda. 
Then add a pinch of the sub-nitrate of bismuth, and heat. 
If sugar is present, we get a black precipitate of metallic 
bismuth. Albumen if present must be removed by precipi- 
tation by heat and then filtration, as if present will also 
give a black precipitate. The sulphur compounds will give 
a black precipitate. To distinguish whether it be due to 
sugar or the last named compounds, we add to the urine a 
small quantity of a solution of acetate of lead, and if the 
precipitate is due to the sulphur compounds, we have here 
a black precipitate. You may use instead of bismuth, lith- 
arge (or oxide of lead,) which will only be turned black by 
the sugar. 

Trommers Test. Add to a small quantity of urine in a 
test tube from 3 to 5 drops of a solution of sulphate of cop- 
per, and then an equal volume of liquor potassa, and heat. 
If sugar is present we get a red precipitate of the sub-oxide 
of copper. 

A precipitate somewhat similar to this is occasionally ob- 
served in the urine of a healthy person by the coloration of 
the earthy phosphates. If this mistake is liable to occur 
the urine should be decolorized by shaking up with animal 



24 HAKE-BOOK OF UHOSCOPY. 

charcoal and filtering, when the test may be applied as 

given. 

Fehling's Test. Mix one volume of Xo. 1 and two vol- 
umes of Xo. 2, dilute with about 50 or 60 c.c. of distilled 
water. To a small quantity of this in a test tube, add an 
equal quantity of urine and heat. 

If sugar is present, we observe the same reaction as we 
had in Trommer's test. 

Mulders Test. (Indigo.) We add to a small quantity of 
urine in a test tube 2 or 3 drops of a solution of indigo, 
then render the reaction neutral or alkaline, by the addition 
of a solution of sodium carbonate, and heat without shak- 
ing. If sugar is present, the blue color disappears and we 
have a pale yellow color. Upon shaking the urine in con- 
tact with air, the blue color may be returned. (The indigo 
solution is made by rubbing up common indigo with Xord- 
hausen sulphuric acid.) 

Fermentation Test. Take three test tubes, fill the first 
with the urine to be tested, the second with a solution of 
glucose, and the third with water. Invert the three below 
the surface of some water. Under each place a small piece 
of German yeast, and allow to stand in a room with a tem- 
perature of about 60 to TO degrees F. for 12 to 24 hours. 
At the end of this time, if some gas be observed in the 
number one and number two, and none in number three, 
sugar is present. If it be observed in number two and not 
in number one and number three, there is no sugar in the 
urine. If there be gas in all three, the yeast is worthless, 
and the test must be repeated with reliable yeast. 

Piffard's Gvpro-Potassic Paste. This is made of sul- 



ABNORMAL CONSTITUENTS. 



25 



phate of copper, one part ; crystallized Rochelle salts, five 
parts ; caustic soda, c. p. two parts ; rub up well in a mor- 
tar. To use, take a piece about the size of a pea, put into 
the test tube, add a little water and boil until dissolved. 
Then add a little urine, and if sugar is present we observe 
the precipitation of the sub-oxide of copper as in Trom- 
mer's test. This paste should be kept in a well stoppered 
vessel and put in a cool place. 

From Xeuiauer & Vogel. Add to a small quantity of 
urine in a test tube a little weak ammoniacal solution of ni- 
trate of silver, and boil for some time. If sugar be present, 
we will get a deposit of metallic silver in the form of a pol- 
ished mirror on the bottom and sides of the test tube. The 
only other substance which will give this reaction with the 
above solution is tartaric acid. 

Add to the urine a solution of caustic potassa, and then 
a few drops of the molybdate or tungstate of ammonia. 
Heat to boiling and then acidulate carefully with hydro- 
chloric acid. You get a blue color if sugar be present. 

If the urine be high colored with any of the above tests, 
it should be shaken up with animal charcoal and filtered. 
To do this, put one or two ounces of the urine in an eight 
ounce bottle, add half an ounce of charcoal and a small 
quantity of carbonate of soda. Shake well for from five to 
ten minutes, and filter. Then when ready to test, acidu- 
late carefully with acetic acid. 



Uroerythrine. 

Uroerythrine is the colorin 

ored fever urines owe their color. It should contain iron. 

The presence of uroerythrine indicates the breaking down 



g matter to which all high col- 



26 HAUD-BOOK ] OF UROSCOPY. 

of blood corpuscles during febrile processes. The foam of 
urine containing much uroerythrine is yellow, and might be 
mistaken for the foam of an icteric urine. To distinguish 
it, add a little acetate of lead solution, when, if it be clue to 
bile, the precipitate will be yellow, while if due to uroery- 
thrine it will be a flesh color or reddish. Uroerythrine oc- 
curs in all febrile conditions but most' frequently in 
pyaemia, liver affections and lead colic. 

Test, by solution of acetate of lead. A solution of 
acetate of lead added to the urine throws down all the col- 
oring matters and some of the salts. The precipitate nor- 
mally is white. If colored a pale flesh color' or pinkish, 
uroerythrine is present. 

Bile. 

There are tests for the biliary acids and for the biliary 
coloring matters. As the biliary acids are found so rarely 
in the urine, we shall not discuss them. 

The coloring matters of the bile found in the urine are 
bilirubin, biliverdin, biliprasin, and bilifuscin. These col- 
oring matters are found, of course, in the bile, biliary cal- 
culi, intestine, and in the excrement. Pathologically, in 
jaundice they are found in all the fluids of the body and 
even pass into the tissues. 

Detection. Urine containing them in large amount is 
always strongly tinged a deep brown, reddish brown, green- 
ish brown, dirty green, or grass green. It foams strongly, 
and colors filter paper yellow or greenish. 

Gmelln's Test. Put about an inch or so of concentrated 
nitric acid which has been decomposed by standing in the 
lioht, and carefully cover this with a layer of urine by 



ABNORMAL COXSTITUEKTS. %*t 

means of a pipette. If the coloring matters of the bile he 
present, we get a play of colors, a green ring which slowly 
rises, and on the lower border have finally a blue, violet, 
red, and yellow ring. Albumen in no wise interferes with 
the test. 

A letter way of conducting this test, is, by adding to a 
drop of urine in a porcelain capsule a drop of the above 
acid, when the play of colors will be better observed. 

To biliverdin is due the green color. 

Heller's Test. Put in a test tube about 6 c.c. of pure 
hydrochloric acid, and then add enough urine drop by drop 
to distinctly color this. Allow 2 or 3 c. c. of pure nitric acid 
to flow down the side and underlie it. If biliary coloring- 
matters are present, you have a play of colors. 

The biliary coloring matters can also be detected by wet- 
ting a clean linen cloth or filter paper with the urine to be 
tested and allow it to dry. It is colored brown if biliary 
coloring matters be present. 

Blood. 

Blood may be found in the urine from disease of the kid- 
ney, disease of the pelvis or ureter, disease of the urethra, 
and in women from uterine discharges such as menstrua- 
tion. If the amount of blood is large, it probably comes 
from the pelvis of the kidney, ureter, or bladder. If from 
the pelvis or ureter, generally pus or gravel is present. 

Detection. If the urine is acid the corpuscles remain nor- 
mal for some time, though generally swollen. Their color 
is generally palish, but more or less sharply defined. All 
these changes are caused by the water. Where the amount 
of blood is small, we allow the urine to stand for some little 



28 HAND-BOOK OP UROSCOPY. 

time in a conical shaped vessel and the corpuscles will settle 
to the bottom as a red sediment. This can be generally 
recognized by the unaided eye as blood. The urine always 
contains more or less albumen if blood is present. 

Tests. Add a little liquor potassa to the urine, heat to 
boiling and allow the earthy phosphates which are separ- 
ated by the alkali, to settle, when if blood be present, 
they carry down the haematine and appear as a brownish 
red, and sometimes as a very handsome blood red precip- 
itate. If this red coloring matter were due to the color- 
ing matter of plants, the phosphates during their precip- 
itation would not carry with them any of the coloring 
matter. 

A few cubic centimeters of tincture of guiac is mixed 
with an equal volume of oil of turpentine and shaken until 
an emulsion is formed, when the urine is added carefully. 
When this emulsion comes in contact with the urine, the 
guiac resin is precipitated as a white, and later on as a dirty 
green precipitate. If the urine contains blood, the resin is 
colored more or less intensely blue. Urine containing al- 
bumen or pus does not give the above reaction. 

To distinguish between the presence of blood and a red 
color from the ingestion of some vegetable matters, we 
add a little nitric acid. If it be due to blood, the color 
is darker. If due to a vegetable coloring matter, it is 
turned brighter. 

Pus. 

Pus when in the urine is more certainly recognized by 
the use of the microscope. Pus settles quickly in an acid 
urine when at rest. 



ABNORMAL CONSTITUENTS. 29 

Donne's Test. Pour the urine from the sediment, or 
extract the precipitate by means of a pipette, and to this 
add a little liquor potassa. If the substance be pus, it 
loses its white color and becomes a clear vitreous mass. 
And this has the consistence of the white of egg. 

Pus may come from any part of the genito-urinary tract. 
If it comes from the pelvis of the kidney, it is less apt 
to be mixed with mucus, and the urine retains its normal 
reaction longer. Pus is readily mixed with the urine and 
is promptly deposited from it. From the bladder how- 
ever, if the urine is not alkaline when voided, it is apt 
to become so very soon from the presence of a large quan- 
tity of mucus. In females you may get pus in the urine 
from leucorrhoea, etc. 



VOLUMETRIC ANALYSIS 



CHAPTER IV. 



Urea. 



Hypobromite Test. Solution is made up with 100 grams 
of caustic soda ; 25 c. c. of bromine ; and 250 c. c. of distil- 
led water. 

The test depends upon the decomposition of urea by the 
above hypobromite solution ; nitrogen being given off is 
measured, and from the amount of nitrogen so disengaged 
is calculated the amount of urea in the quantity of urine 
used. (5 c. c.) 

Process. A tall glass cylinder, 22 inches high and 2 
inches wide, is filled with water. In this a burette of 100 
c. c. is inverted. A rubber tube connects the end of the 
burette with a mixing flask. (Any two ounce wide mouthed 
vial will answer the purpose.) The stopper of the mixing 
bottle flask has two holes in it : through each of these a piece 
of glass tubing is put, to one is attached the tube from the 
burette and to the other a piece of tubing on which is a pinch 
cock. In the flask is placed 15 c.c. of the hypobromite solution. 
5 c. c. of the urine is put in a small tube (a test tube broken 
off near the end answers the purpose very well) and carefully 
placed (tvithoict mixing with the hypobromite solution) in 
the bottle. The stopper is now placed in and pressed firmly 



YOLUMETEIC ANALYSIS. 31 

in place, and the pinch cock closed. The reading on the bu- 
rette is now taken and noted. The urine and the hypobromite 
solution are then allowed to mix, the flask being shaken up. 
They should be well shaken, and the decomposition allowed 
to continue for at least three-quarters of an hour, and during 
this time the surface within the burette should be kept at a 
evel with that on the outside. At the end of this time the 
reading is again taken. The difference between the two 
readings multiplied by .0027 gives the number of grams of 
urea in 5 c. c. of urine used. From this can be easily cal- 
culated the amount in the whole quantity. 

The reason for multiplying by .0027, is that .0027 of a 
gram of urea when decomposed by the above solution gives 
off 1 c. c. by measure of nitrogen gas. 

Hypochloeite Test. Take of Labarraque's solution, 
(liquor sodas chlorinatas, Squibb's) seven parts, and the urine 
one part. Get specific gravity of mixed solutions. After 
decomposition, which should take two hours, get the specific 
gravity. Subtract the specific gravity of the mixture 
before decomposition took place, and multiply the differ- 
ence by . 77, and you have the per cent, of urea. To get 
the specific gravity of the mixed urine before decomposi- 
tion, multiply the specific gravity of the hypochlorite so- 
lution by 7, add the specific gravity of the urine and divide 
by 8. Ex. Suppose that of the hypochlorite solution is 
1045 and that of the urine 1010, then 1045 by 7 plus 1010, 
divided by 8 = 1040 — the specific gravity of the mixture 
before the reaction. 

(Jhloeide of Sodium. 
Standard solution required is made up by dissolving 14.53 



32 HAND-BOOK OF UROSCOPY. 

grams of nitrate of silver in 1000 c. c. of distilled water. 
20 c. c. of this solution equals one decigram of chloride of 
sodium. 

A saturated solution of chromate of potash. 

Process. Put 100 c. c. of filtered urine in a beaker. Add 
four times as much distilled water with 2 or 3 drops of the 
chromate of potash solution. Render the reaction neutral 
or faintly alkaline by carbonate of soda or nitric acid, as the 
case requires. Bring the beaker uuder the burette filled to 
the mark with the standard solution of nitrate of silver. 
Add in small quantities at a time until the last addition is 
followed by a permanent red appearance. Get the number 
of c. c. of nitrate of silver solution used and divide this by 
20, and you have the number of grams of chloride of sodium 
per litre of urine. 

We do this because the standard solution is made up so 
that 20 c. c. equal one decigram of chloride of sodium. Then 
dividing by 20 gives the number of decigrams of chloride of 
sodium in 100 c. c, and in 1000 c. c, or a litre, there would 
be ten times as much, or just so many grams instead of 
decigrams . 

Phosphoric Acid. 

Standard Solution of Nitrate of Uranium. Dissolve 35.2 
grams of nitrate of uranium in 1000 c. c. of distilled water. 
20 c. c. of this solution equal one decigram of phosphoric 
acid. 

Solution of Acetate of Sodium. Dissolve 50 grams of 
acetate of soda in 500 c. c. of distilled water and add 50 c.c. 
of acetic acid. 

Solution of Ferrocyanide of Potassium, strength of one to 
ten. 



VOLUMETRIC - ANALYSIS. ; 33 

Process. Put 100 c. c. of urine in a beaker, add 25 c. c. 
of the solution of acetate of soda, a little water, and warm. 
Have a slip of white glass or a porcelain capsule handy on 
which is several drops of the ferrocyanide solution. 

When the mixture is warm, bring it under the burette 
filled with the standard solution of nitrate of uranium, and 
titrate carefully. When a drop from the beaker brought in 
contact with a drop of ferrocyanide strikes a brown color, 
the analysis is terminated, and the number of c. c. used di- 
vided by 20 will give the number of grams of phosphoric 
acid per litre of the urine. 

Sulphuric Acid. 

Standard solution of barium chloride ; dissolve 15.25 
grams of chloride of barium in 1000 c. c. of distilled water. 
20 c. c. of the solution equals one decigram of sulphuric 
acid. 

Solution of sulphate of soda, strength of one to ten. 

Process. Put 100 c. c. of urine in a beaker, add about 
200 c. c. of distilled water, a little hydrochloric acid, and 
place the mixture in a water bath or hold over a spirit 
lamp until hot. Fill the burette to the mark with the 
standard solution of barium chloride and bring the beaker 
under it. Permit a small portion of this solution to drop 
into the beaker and allow precipitate of sulphate of barium 
to settle. Continue addition carefully, allowing mixture to 
settle each time until there is a clear strata of fluid above. 
Then add a drop or two more of the barium chloride. If 
this causes a fresh precipitate continue carefully as before, 
but if no precipitate .occurs, bring a drop- of the clear fluid 
in contact with a drop of the -solution of- snlphate of- soda ; 



34 



HAND-BOOK OF UROSCOPY. 



if now a dense white precipitate appears, it shows too much 
chloride of barium has been added to the urine and the 
analysis must be repeated. The number of c.c. of standard 
solution finally determined on as necessary for the precipi- 
tation of all the sulphuric acid, divided by 20 will give the 
number of grams of sulphuric acid per litre of urine. 

Albumen. 

Take 25 c. c. of the urine, acidulate carefully with acetic 
acid if not already acid, and heat until the albumen is all 
precipitated. Then filter this through a previously weighed 
dry filter. Place the filter with the precipitate upon it in 
a water oven and keep there until perfectly dry. Then al- 
low it to cool in a desiccator and weigh. The difference be- 
tween the weight of the filter before and after filtering gives 
the amount of albumen in 25 c.c. of urine. The amount of 
albumen in the 24 hours can then be reaclilv calculated. 



Sugar. 

Fehling's solutions consist of two solutions, No. 1 and 
No. 2. 

Solution No 1. Made by dissolving 51.98 grams of c. p. 
sulphate of copper in 500 c. c. of distilled water. 

Solution No. 2. 259.9 grams of Rochelle salts, c. p., dis- 
solved in 1000 c. c. of a solution of caustic soda, c. p. of a 
specific gravity of 1.12. 

Process. Mix one volume of No. 1 with two volumes of 
No. 2. Put 20 c. c. of the mixed solution in a flask, 
dilute with 60 c. c. of distilled water, and boil, Dilute the 



VOLUMETRIC ANALYSIS. 35 

urine with 4 volumes of water. Fill the burette to the 
mark with the diluted urine. When the Fehling's solution 
boils, bring it under the burette and add the urine very 
carefully, a little at a time, until all the blue color is dis- 
charged and a faint red color is present. Then divide the 
number of c. c. used by 5 and the quotient is the number 
of c. c. of urine containing one decigram of sugar. 



CHEMICALS AND APPARATUS. 



CHAPTER V. 

Chemicals. • 

CII. P. Nitric Acid. 

OH. P. Hydrochloric Acid. 

CH. P. Colorless Sulphuric Acid. 

Pare Acetic Acid. 

Liquor Potassa of the U. S. P. 

Solution of Sodium Carbonate, one part of the crystalized 
salt to three parts water. 

Solution of Barium Chloride,, four parts crystalized barium 
chloride, sixteen of distilled water and one of hydrochloric 
acid. 

Magnesian Mixture : containing magnesium sulphate and 
ammonium chloride, each one part, distilled water eight. 
parts, pure liquor ammonia one part. 

Solution of Sulphate of Copper, ten grains to the ounce. 

Solution of Nitrate of Silver, one part to eight of distilled 
water. 

Solution of Acetate of Lead, one part to four of distilled 
water. 



chemicals and apparatus. 3? 

Apparatus. 

Half a dozen five inch, and half a dozen six inch test tubes. 

A Test Tube, on foot. 

Test Tube Rack and Drainer. 

2 Conical Glasses. 

Red. and Blue Litmus Paper. 

Filter Paper. 

LTrinometer, with a scale from 1000 to 1050 or 1000. 

Spirit Lamp. 

3 Porcelain Capsules. 

2 Nests of Beakers, 3 each. 

3 Glass Funnels. 
Glass Stirring Rod. 
Pipette. 

1 Wash Bottle. 

1 Test Tube Cleaner. 

Set of 13 bottles with glass blown labels, of 4 ounce ca- 
pacity, are preferable to any other. Care should betaken 
that the stoppers of the liquor potassa, barium chloride, 
magnesian mixture, acetate of lead, and carbonate of soda 
bottles are parafmed. 

For Volumetric Work. 

Burette of 100c. c, and one of 50 c.c. with float and pinch 
cock, and a clamp for burette. 

Pipettes, one each of 100, 50, 25, 15, 10, and 5 c. c. 

1 Litre Flask. 

1 Graduated. Cylinder, Stoppered, 500 c. c. 

Sand Bath, Water Ovens, etc. 



I N D E X 



Albumen. 20. 

test by heat, 21. 
test by nitric acid, 21. 
quantitative test for, 31. 

Bile, 26. 

Biliary acids, 26. 

Biliary coloring matter, 20. 
Gmelin's test for, 26. 
Heller's test for, 27. 

Blood, 27. 

detection of, 27. 
test for, 28. 

Chlorides, 12. 

test for. 13. 

Creatine, 19. 

Creatinine, 19. 

Chloride of sodium, volumetric test for, 31. 

Coloring matters, 16. 

Hippuric acid, 19. 

Indican, 17. 

pathological significance of, 17. 
test for, 17. 

Lactic acid, 19. 

Mucus, 19. 

Oxalic acid, 19. 

Phosphates, earthy, 13. 

Hofmann & Ultzmann's test for, 13. 
Phosphates, alkaline. 14. 

test for, 14. 
Phosphoric acid, 15. 

volumetric analysis for, 32. 

Phenylic acid, 19. 



Pus, 28. 

Donne's test for, 59. 

Sulphates, 15. 

test for, 16. 

Sugar, 22. 

Moore's or Heller's test for, 23. 
Boettger's test for, 23. 
Tromrner's test for, 23. 
Fehling's test for, 24. 
Mulder's test for, 24. 
fermentation test for, 24. 
Piffard's copper test for, 24. 
Neubauer & Vogel's test for, 25. 
volumetric analysis for, 34. 

Sulphuric acid, 33. 

volumetric process for, 33. 

Solutions, Labarraque's, 31. 
hypobromite, 30. 
nitrate of silver, 31. 
chromate of potash, 32. 
nitrate of uranium, 32. 
acetate of sodium, 32. 
ferrocyanide of potassium, 32. 
barium chloride, 33. 
sulphate of soda, 33. 
Fehling's, No. 1, 34. 
Fehling's, No. 2, 34. 

Urine, physical properties, 3. 

normal constituents, 11. 
abnormal constituents, 20. 
volumetric analysis of, 30. 
chemicals for examination of, 30. 
apparatus for examination of, 37. 
quantity of, 4. 
color of, 4. 
odor of, 6. 
consistence of, 7. 
specific gravity of, 7. 
solid matters of, 8. 
reaction of, 9. 
coloring matters of, 16, 



Urea, li. 

test for, 12. 

volumetric analysis for, by hypobro- 
raite test, 30. 
by hypochlorite test, 31. 
Uric acid, 17. 

mnrexid test for, 18. 

Urates, 18. 

test for, 10. 



Urobilin, 1G. 

test for, li 



Uroerythrine, 25. 

test for, 2G. 



Xanthin, 10. 



